Athletes and Irritable Bowel Syndrome
by Melinda Burris

This article explores the subject of irritable bowel syndrome (IBS), a common health syndrome among people in general and particularly in active athletes with a high consumption of carbs, the added stressors of pushing their bodies to achieve new performance peaks, and the worries associated with rising to meet competition expectations. Strategies for managing the condition and avoiding exacerbating symptoms are discussed.

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Hurdles and other track events require explosive power, high endurance training, and competition. Writer Rob Hobson points out that one of the reasons these athletes may experience a higher rate of GI distress is that “During intense endurance exercise, blood flow is directed away from the gut to working muscles in the body, which can lead to reduced motility (the movement of food through the gut) and increased permeability to the gut lining.”¹ This can lead to a number of symptoms indicating GI upset, such as stomach pain, diarrhea, and nausea—commonly grouped together and referred to as exercise-induced gastrointestinal distress.¹

Because of the extra demands athletes place on their bodies, they are at heightened risk of developing irritable bowel syndrome.¹

The Effects Dietary Changes Can Cause

Athletes are constantly striving to meet the dietary needs of their bodies through the stages of their training—pre, during, and post-workout/competition. Obviously, your gut reacts to changes in consumption as the digestive system must deal with the change in demand for its services.¹ Make considered choices, so that you do not go from one extreme to another, causing the body to experience an imbalance.

Psychological Pressure

“Race day nerves” can put additional stress and strain on you mentally, which can express itself in a physical way by causing GI distress. It’s essential to have a game day plan to avoid this.¹

Techniques for Avoiding GI Distress:

• Gradually increase carbohydrate intake

Athletes often alter their dietary intake to increase performance. For endurance athletes, upping carb consumption is normal, but increasing intake too much or too fast can have a negative impact, as it can cause GI distress.¹ It is better to slowly increase your consumption of these foods so the body can become accustomed to digesting them. Doing so during training workouts will slowly acclimate the body and avoid any competition day surprises and/or distress that could threaten your ability to compete effectively.

It is vital that individuals with IBS be mindful of limiting their consumption of short-chain carbohydrates. These carbs are known to “ferment in the gut,” meaning they hang around and trigger various digestive issues, including bloating, flatulence, and abdominal pain.²

Examples of foods that fall under the category of short-chain carbs include:²

Garlic

Onions

Apples

Cherries

Peaches

Asparagus

Cauliflower

Legumes

Lentils

Chickpeas

Dairy Products

• Modify your workouts as needed

Keep a journal of your training sessions, noting any exercises that cause or aggravate GI irritation. Sit-ups and crunchies are examples of exercises that could inflame an already aggravated abdominal area.¹

• Address anxiety

Do your best to identify and deal with psychological stress triggers. This may involve trying a number of proven methods for anxiety management until you find the one or combination of techniques that work best for you. Some strategies you can try are deep breathing exercises, meditation, yin yoga, restorative yoga, and/or guided visualization.¹

Of course, while it is impossible to avoid anxiety entirely, it is essential to get to the root of what is causing your stress to begin with. As the adage goes, a pound of prevention is worth a ton of cure. Speak to a therapist and identify issues to assist in ways to not only manage stress but also avoid stressors before they impact you mentally and physically.¹ Your mind and body will thank you, and your performance will no doubt flourish!

In addition to stress, athletes who suffer from IBS should be especially vigilant about staying well hydrated, as Hobson explains that “dehydration can worsen symptoms and negatively impact athletic performance.”¹

• Use medication or probiotics as needed

Healthcare providers may prescribe an antispasmodic medication to relieve stomach pain and cramping if it is moderate to severe. Supplements known as probiotics have also been shown to be effective in treating GI distress in a literature review study involving more than 30 research studies involving participants diagnosed with IBS.¹

The findings of a research study conducted at the University of Illinois suggest that IBS may often go undiagnosed among athletes. The study involved 430 endurance athletes who participated by means of a survey. Though approximately half of those surveyed reported symptoms associated with IBS, using the current diagnostic method, they would not meet the threshold for an IBS diagnosis. However, if the previous diagnostic standard were used, they would.²

Soo-Yeun Lee, a UoI professor of food science who co-wrote the research study, made an important point when she emphasized that negative impacts and restrictions on competition for elite athletes caused by IBS result in less income and can negatively impact their career to the point of derailing it.²

Timing Is Key

As with almost everything when it comes to training and competition, timing is of extraordinary importance at all stages of meals. You never want to alter your consumption of types or amounts of foods on heavy training days and definitely not on competition days.³

You always want to give your body time to convert foods into energy stores (glycogen) so your muscles can perform their best. If you have an all-day event, remember to eat at regular intervals throughout the day to keep those glycogen stores at a steady level. ³

If you are experiencing symptoms of IBS, nausea, abdominal pain, cramping, and/or diarrhea, consult your healthcare provider. If possible, bring a dietary journal with you to the appointment as this will help them in their diagnosis. Be honest with the provider about any feelings of stress you feel about competing or training, so those feelings can be addressed as well.

References:

1. Hobson, R. 25 April 2023. Digestive (GI) problems are common among athletes. Sports nutritionist Rob Hobson outlines the reasons why and what you can do to minimize the impact.
2. Forrest, S. 13 June 2019. Study: Irritable bowel syndrome may be underdiagnosed in athletes.
3. Tallent, K. 4 March 2024. Nutrition strategies for athletes with irritable bowel syndrome on distance adventures.

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